MEDICARE: TAMPA BAY RADIOSURGERY MANAGEMENT HILLSBOROUGH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QX0203X	Radiation Oncology Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0009M	OTHER	FL	BCBSFL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407016678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAMPA BAY RADIOSURGERY MANAGEMENT HILLSBOROUGH LLC

Provider Business Mailing Address
First Line	:	5935 WEBB RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-3219
Country	:	US
Telephone Number	:	813-884-7400
Fax Number	:

Provider Business Practice Location Address
First Line	:	5935 WEBB RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-3219
Country	:	US
Telephone Number	:	813-884-7400
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. HARVEY MICHAEL GREENBERG
Credential	:	MD, MBA
Telephone Number	:	813-884-7400

Provider Enumeration Date	:	06/11/2008
Last Update Date	:	06/24/2010

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